Breathing Re-education

Breathing therapy concentrates on breath and life, which are obviously intertwined, as are breath and thought. It is by means of the breath that we remain physically alive. As babies we are born with the inherent knowledge to breathe correctly through our diaphragm, but as we grow into toddlers, children and onto adulthood our life experiences and emotions influence and change our unique pattern of breathing.

Gerry Gajadharsingh estimates that 70% of patients that consult him do NOT breathe properly.

Sighing a lot, difficulty in catching breath and talking very fast are all signs of not breathing properly. We often hear expressions, such as “take a deep breath and count to 10”, before reacting to something that has upset us.

It is no co-incidence that Chi Kung, Tai Chi, Pilates, Yoga and meditation all play significant attention to breathing as their main way of helping people relax. Many of these approaches have validated scientific evidence of their effectiveness in helping many medical conditions from pain to cardiovascular disease.

Many patients with medically unexplained symptoms (a proportion of those attending GP practices) will have Breathing Pattern Disorder as part, if not sometimes the main part, of their problem.

We need to understand that in diagnosis the normal medical model tries to find pathology – an obvious disease process. Luckily for us, the majority of time, no defined pathology exists. However, there is usually a cause of peoples problems; the answer can often be found in what we call functional disturbance. This can occur on a biomechanical, biochemical/nutritional, psycho/social/emotional level, or indeed a combination of all of these levels.

What links all 3 levels is breathing.

We breathe in oxygen (O2), we breathe out carbon dioxide (CO2). The main aim of respiration is to get O2 into cells to help with energy production and the many cellular reactions that our bodies need to survive – this action is dependent on an adequate level of CO2 being present in our bodies.

Almost always, when people are not breathing properly, the issue is one of overbreathing.

The effect of this is to breath out too much CO2 causing the levels of CO2 in our body to drop (hypocapnia) and reducing the ability of O2 to be delivered to the cells of the body (hypoxia).

Ironically trying to breathe more O2 in DOES NOT necessarily help this situation.

Somebody who is classically hyperventilating (deep and fast breathing), often with symptoms of breathlessness and panic, is breathing in lots of O2 but is actually expelling more CO2 then they should. So, the treatment for acute hyperventilation is to hold a brown paper bag over their mouth and nose, so that they re-breath their own breath (mostly CO2); they return to normal because their cellular O2 levels increase.

How is a Breathing Pattern Disorder (BPD) diagnosed?

Apart from the history and habits described above, the right clinical examination can be very revealing.

The Breath Pause – Patients with a breath pause of less than 30 seconds may be suggestive of BPD

Observation – Upper ribcage breathing and poor diaphragmatic use may be suggestive of BPD

Breathing Rate – Optimum breathing is about 6 cycles per minute, an average patient breathes about 12 cycles per minute. A BR of more than 15 per minute may be suggestive of BPD

Nijmegen Questionnaire – This validated questionnaire can be suggestive of BPD if the patient scores highly

Capnography – This specialised piece of equipment measures CO2 levels and breathing rate and is the most scientific method of diagnosing BPD

Once diagnosed BPD can be subdivided into two categories:

Intermittent Over-breathing (mostly situational)

Chronic Over-breathing

Treatment for Intermittent Over-Breathing

The following treatments may be used in conjunction with each other, or in isolation, depending on the complexity of the problem:

Osteopathic hands on work – to improve neck function (nerve supple to diaphragm), direct work to the thoracic spine, rib cage and associated soft tissues, muscle and fascia to improve local mechanics and decrease sympathetic arousal.

Hypnotherapy/psychotherapy to look at sub-conscious patterns and situational emotional triggers

Treatment for Chronic Over-Breathing

Chronic Over-breathing is treated with some, or all, of the treatments offered for Intermittent Over-breathing. Additionally Capnotraining may be used.

Capnotraining involves a minimum of four weekly, one to one, 45 minute sessions, which include use of the CapnoTrainer and hands on osteopathic work. This ideally needs to be complemented with personal capnotraining work. For this we recommend purchasing a CapnoTrainer.

Gerry’s up to date knowledge of Breathing Mechanics and physiology combined with Osteopathy, make a potent and immediately effective intervention in breathing disorders and stress management. Highly informative and recommended.

Mr Mojo Rathbone DO, Osteopath, Cambridge, UK

I first came across his work as an Advanced Breath Practitioner over three years ago and to this day I still quote his lecture and the revelation of the therapeutic benefits of a good and coordinated breath. It certainly changed my scope of practice.

Ms Alison Lynn DO, Osteopath, Sydney, Australia

I have seen Gerry regularly and continue to be impressed with his ability to evaluate and respond to symptoms in a holistic manner, treating the person not the symptoms. I never hesitate to recommend him to others with similar complaints, whose feedback suggests their experiences have been at least as positive as my own.